Which of the following is NOT a recognized long-term anticoagulation indication?

• A. Afib
• B. VTE (DVT and PE)
• C. Pulmonary hypertension
• D. Mechanical heart valves

Answer: (C)

Long-term anticoagulation is used when there is a sustained risk of thromboembolism that can cause serious harm. Atrial fibrillation creates blood stasis in the atria, increasing the risk of embolic stroke, so anticoagulation is a standard long-term strategy. Venous thromboembolism (DVT and PE) carries a high chance of recurrence if not treated long enough, so extended anticoagulation is commonly used. Mechanical heart valves have a strong risk of thrombosis on the valve itself, making lifelong anticoagulation necessary.

Pulmonary hypertension, on the other hand, is a label for various disorders affecting the pulmonary arteries and pressures, and it is not by itself a blanket indication for chronic anticoagulation. Anticoagulation may be considered in specific subtypes (for example, chronic thromboembolic pulmonary hypertension or certain cases of pulmonary arterial hypertension), but as a general rule PH by itself does not constitute a standard long-term anticoagulation indication.